High yield of culture-based diagnosis in a TB-endemic setting

BMC Infectious Diseases

Research Article

David Coetzee¹  Andrew Boulle¹  Robin Warren²  Paul van Helden²  Marcel A Behr³  Anne-Marie Demers⁴  Suzanne Verver⁵ 

[1] Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa;DST/NRF Centre of Excellence for Biomedical TB Research/ US/MRC Centre for Molecular and Cellular Biology, Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Health Sciences - Stellenbosch University, PO Box 19063, 7505, Tygerberg, South Africa;Department of Medicine, McGill University, Montreal, Québec, Canada;McGill University Health Centre, Room A5.156, 1650 Cedar Avenue, H3G 1A4, Montreal, QC, Canada;Département de Microbiologie et Immunologie, Université de Montréal, Montreal, QC, Canada;CHU Sainte-Justine, 3175 Chemin de la Côte Sainte-Catherine, H3T 1C5, Montréal, QC, Canada;KNCV Tuberculosis Foundation, The Hague, The Netherlands;CINIMA, Academic Medical Centre Amsterdam, Amsterdam, The Netherlands;

关键词: Tuberculosis;    Diagnosis;    Culture;    Microscopy;   

DOI  :  10.1186/1471-2334-12-218

 received in 2012-01-12, accepted in 2012-09-05,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundIn most of the world, microbiologic diagnosis of tuberculosis (TB) is limited to microscopy. Recent guidelines recommend culture-based diagnosis where feasible.MethodsIn order to evaluate the relative and absolute incremental diagnostic yield of culture-based diagnosis in a high-incidence community in Cape Town, South Africa, subjects evaluated for suspected TB had their samples processed for microscopy and culture over a 21 month period.ResultsFor 2537 suspect episodes with 2 smears and 2 cultures done, 20.0% (508) had at least one positive smear and 29.9% (760) had at least one positive culture. One culture yielded 1.8 times more cases as 1 smear (relative yield), or an increase of 12.0% (absolute yield). Based on the latter value, the number of cultures needed to diagnose (NND) one extra case of TB was 8, compared to 19 if second specimens were submitted for microscopy.ConclusionIn a high-burden setting, the introduction of culture can markedly increase TB diagnosis over microscopy. The concept of number needed to diagnose can help in comparing incremental yield of diagnosis methods. Although new promising diagnostic molecular methods are being implemented, TB culture is still the gold standard.

【 授权许可】

Unknown   
© Demers et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.